The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, Washington, USA
The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, Washington, USA.
BMJ Open. 2023 Apr 3;13(4):e069195. doi: 10.1136/bmjopen-2022-069195.
INTRODUCTION: Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition, but coverage remains low in high prevalence settings. Initiating and continuing PrEP via online pharmacies is a promising strategy to expand PrEP uptake but little is known about user preferences for this strategy. We describe methods for a discrete choice experiment (DCE) to assess preferences for PrEP delivery from an online pharmacy. METHODS AND ANALYSIS: This cross-sectional study is conducted in Nairobi, Kenya, in partnership with MYDAWA, a private online pharmacy retailer with a planned sample size of >400 participants. Eligibility criteria are: ≥18 years, not known HIV-positive and interested in PrEP. Initial DCE attributes and levels were developed via literature review and stakeholder meetings. We conducted cognitive interviews to assess participant understanding of the DCE survey and refined the design. The final DCE used a D-efficient design and contained four attributes: PrEP eligibility assessment, HIV test type, clinical consultation type and user support options. Participants are presented with eight scenarios consisting of two hypothetical PrEP delivery services. The survey was piloted among 20 participants before being advertised on the MYDAWA website on pages displaying products indicating HIV risk (eg, HIV self-test kits). Interested participants call a study number and those screened eligible meet a research assistant in a convenient location to complete the survey. The DCE will be analysed using a conditional logit model to assess average preferences and mixed logit and latent class models to evaluate preference heterogeneity among subgroups. ETHICS AND DISSEMINATION: This study was approved by the University of Washington Human Research Ethics Committee (STUDY00014011), the Kenya Medical Research Institute, Nairobi County (EOP/NMS/HS/128) and the Scientific and Ethics Review Unit in Kenya (KEMRI/RES/7/3/1). Participation in the DCE is voluntary and subject to completion of an electronic informed consent. Findings will be shared at international conferences and peer-reviewed publications, and via engagement meetings with stakeholders.
介绍:暴露前预防 (PrEP) 在预防 HIV 感染方面非常有效,但在高流行地区的覆盖率仍然很低。通过在线药店启动和继续 PrEP 是扩大 PrEP 使用率的一种有前途的策略,但对于这种策略,用户的偏好知之甚少。我们描述了使用离散选择实验 (DCE) 来评估通过在线药店提供 PrEP 的偏好的方法。
方法和分析:这项横断面研究是在内罗毕进行的,与 MYDAWA 合作,这是一家私人在线药店零售商,计划的样本量超过 400 名参与者。合格标准是:年龄≥18 岁,不知道 HIV 阳性,对 PrEP 感兴趣。初始 DCE 属性和级别是通过文献回顾和利益相关者会议开发的。我们进行了认知访谈,以评估参与者对 DCE 调查的理解,并对设计进行了改进。最终的 DCE 使用了高效设计,包含四个属性:PrEP 资格评估、HIV 检测类型、临床咨询类型和用户支持选项。参与者将看到由两个假设的 PrEP 交付服务组成的八个场景。该调查在 MYDAWA 网站上显示 HIV 风险产品(例如 HIV 自我检测试剂盒)的页面上进行了预试验。有兴趣的参与者拨打研究号码,经过筛选符合条件的参与者将在方便的地点与研究助理见面以完成调查。DCE 将使用条件逻辑模型进行分析,以评估平均偏好,并使用混合逻辑和潜在类别模型评估亚组之间的偏好异质性。
伦理和传播:这项研究得到了华盛顿大学人类研究伦理委员会(STUDY00014011)、肯尼亚医学研究所内罗毕县(EOP/NMS/HS/128)和肯尼亚科学和伦理审查单位(KEMRI/RES/7/3/1)的批准。DCE 的参与是自愿的,并须完成电子知情同意书。研究结果将在国际会议和同行评审出版物上分享,并通过与利益相关者的参与会议分享。
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